A new study has found that the brain may play an important role in glucose metabolism and the development of type 2 diabetes.
Since the discovery of insulin and its blood sugar -regulating properties in the 1920s, researchers have focused almost exclusively on treatments for diabetes that either boost insulin levels or increase the body’s sensitivity to the hormone.
But new research, published in the latest issue of the journal Nature, suggests that normal glucose regulation is dependent on a relationship between insulin-producing islet cells in the pancreas and circuits of neurons in the hypothalamus and other areas of the brain that are closely involved in maintaining normal glucose levels.
When both this brain-centred regulatory system and the islet-cell system fail, it causes a vicious cycle that results in the development of type 2 diabetes, the authors state.
For the study, Dr. Michael W. Schwartz, director of the Diabetes and Obesity Center of Excellence at the University of Washington in Seattle, and his colleagues from the universities of Cincinnati, Michiga, and Munich reviewed studies indicating the insulin-independent effect of the brain-centred system on blood sugar.
They found that one way in which this system promotes the uptake of glucose by tissues is by triggering a process known as “glucose effectiveness”, which has a similar effect as insulin-dependent mechanisms driven by the pancreatic islet cells.
Based on their findings, the researchers concluded that restoring normal glucose regulation could be achieved by using a two-system model consisting of the islet-cell system, which responds to rising glucose levels by releasing insulin, and the brain-centered system that improves insulin-mediated glucose metabolism while also stimulating glucose effectiveness.
By combating the underlying causes of type 2 diabetes, such an approach, they said, would help improve blood glucose control in patients with type 2 diabetes and could cause their condition to go into remission.

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